Human venous blood derivatives as fetal bovine serum substitute for fibroblast culture cells in a fibrin construct

Aim: Venous blood derivatives (VBDs) have been suggested as substitutes for Fetal Bovine Serum (FBS) to improve the clinical transition of cell-based therapies. The literature is not clear about which is the best VBDs substitute. The present study aimed to evaluate the influence of VBDs on cell viability and describe a new method to seed these cells in a 3D Platelet-Rich Fibrin (PRF). Methods: Blood was processed to obtain Platelet-Poor Plasma from PRF (P-PRF), Human Serum (HS), Platelet-Poor Plasma from PRP (P-PRP), activated-PRP (a-PRP), and Platelet lysate (PL). Cells were supplemented with each VBD at 10% and FBS at 10% was the control. Cell viability (fibroblast 3T3/NIH) test was evaluated with MTT assay in two ways: i) cell-seeded and expanded with VBD; ii) cell-seed with FBS and expanded with VBD. To seed the Fibrin construct, cells were suspended in PBS and dropped into the blood sample before performing Choukroun's protocol for PRF. Constructs were cultured for 7 days in VBD supplements and FBS. Histological and Immunohistochemical analysis with vimentin was performed. Cell viability was analyzed by one-way ANOVA. Results: VBD's production time was very heterogeneous. Cells expanded in HS and a-PRP has grown faster. VBD-supplemented culture media provided cell culture highly sensible to trypsin/EDTA 0.25%. Cells seeded and expanded with VBD presented viability comparable to FBS in HS, a-PRP, and P-PRP (p>0.05) and lower in P-PRF and PL groups (p<0.05). The viability of cell seed with FBS and expanded with VBD was similar between P-PRF, a-PRP, PL, and FBS (p>0.05) and lower in HS and P-PRP (p<0.005). PRF-seeded cells showed a positive expression of vimentin and were able to maintain all cells supplemented with VBD. Conclusion: VBD supplements were able to maintain fibroblast cells in 2D and 3D cultures. The new method of the fibrin-cell construct was efficient to insert the cells into the fibrin network

Genome sequencing reveals molecular subgroups in oral epithelial dysplasia

Abstract This study aimed to analyze the molecular characteristics of oral epithelial dysplasia (OED), highlighting the pathways and variants of genes that are frequently mutated in oral squamous cell carcinoma (OSCC) and other cancers. Ten archival OED cases were retrieved for retrospective clinicopathological analysis and exome sequencing. Comparative genomic analysis was performed between high-grade dysplasia (HGD) and low-grade dysplasia (LGD), focusing on 57 well-known cancer genes, of which 10 were previously described as the most mutated in OSCC. HGD cases had significantly more variants; however, a similar mutational landscape to OSCC was observed in both groups. CASP8+FAT1/HRAS, TP53, and miscellaneous molecular signatures were also present. FAT1 is the gene that is most affected by pathogenic variants. Hierarchical divisive clustering showed division between the two groups: "HGD-like cluster" with 4HGD and 2LGD and "LGD-like cluster" with 4 LGD. MLL4 pathogenic variants were exclusively in the "LGD-like cluster". TP53 was affected in one case of HGD; however, its pathway was usually altered. We describe new insights into the genetic basis of epithelial malignant transformation by genomic analysis, highlighting those associated with FAT1 and TP53. Some LGDs presented a similar mutational landscape to HGD after cluster analysis. Perhaps molecular alterations have not yet been reflected in histomorphology. The relative risk of malignant transformation in this molecular subgroup should be addressed in future studies.

Whole-exome sequencing of oral epithelial dysplasia samples reveals an association with new genes

Abstract The genetic basis of oral epithelial (OED) is unknown, and there is no reliable method for evaluating the risk of malignant transformation. Somatic mutations are responsible for the transformation of dysplastic mucosa to invasive cancer. In addition, these genomic variations could represent objective markers of the potential for malignant transformation. We performed whole-exome sequencing of 10 OED samples from Brazilian and Chilean patients. Using public genetic repositories, we identified 41 deleterious variants that could produce high-impact changes in the amino acid structures of 38 genes. In addition, the variants were filtered according to normal skin and Native American genome profiles. Finally, 13 genes harboring 15 variants were found to be exclusively related to OED. High-grade epithelial dysplasia samples showed a tendency to accumulate highly deleterious variants. We observed that 62% of 13 OED genes identified in our study were also found in head and neck squamous cell carcinoma. Among the shared genes, eight were not identified in oral squamous cell carcinoma. To our knowledge, we have described for the first time 13 genes that are found in OED in a Latin American population, of which five genes have already been observed in oral squamous cell carcinoma. Through this study, we identified genes that may be related to basal biological functions in OED.

Does smoking habit affect dendritic cell expression in oral squamous cell carcinoma?

Abstract: The aim of this study was to determine the presence of immature CD1a+ and mature CD83+ dendritic cells in oral squamous cell carcinoma, to compare immunoreactivity between smokers and nonsmokers, and to correlate the results with histopathological grading. In this observational study, twenty-eight paraffin-embedded biopsies of oral squamous cell carcinoma were retrospectively retrieved and submitted to immunohistochemistry for immature CD1a+ and mature CD83+. Descriptive and statistical analyses were performed. The sample consisted of 18 man (64.3%) and 10 women (35.7%), with a mean age of 64.6 years in the nonsmoker group and 53.2 years in the smoker group. The tongue (11 cases, 39.2%) was the most commonly affected anatomical site, followed by gingiva (6 cases, 21.4%). Histopathological grading revealed 7 low-grade and 7 high-grade malignancy cases in each group, and no correlation with the number of positive DCs. The number of immature CD1a+ was not significantly different between smoker and nonsmoker groups, while a lower number of mature CD83+ was detected in the smoker group (p = 0.001). Smoking changes the oral immune system and decreases the ability to activate and mature dendritic cells, which may influence the development and progression of oral squamous cell carcinoma.

Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10, 381 cases and literature review

Abstract The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

Methods and logistics of an oral health cohort of university students from Pelotas, a Brazilian Southern city

Aim: This paper aimed to describe the methodological aspects in the baseline of university students' cohort in a public university in southern Brazil. Methods: A multidisciplinary study was carried out assessing the psychosocial and oral health conditions of university students at the Federal University of Pelotas (UFPel). All new university students who have entered in in UFPel in the first semester of 2016 year were invited to participate. Two self-administered questionnaires were applied in classrooms. Descriptive analysis was performed using Stata 14.0. Results: A total of 3,237 students were eligible. Of these, 2,089 (64.5%) signed the consent form to participate of the study and answered the general questionnaires, and 2,052 (63.4%) students answered the confidential questionnaire. Refuses represented only 1.4% (n=29) of the total sample. Overall, most of the sample was female (52.2%), with age ranging from 18 to 24 years (66.1%), with white skin color (74.1%) and with mothers with educational level at university course (32.4%). A total, 62% reported a family income between 1001.00 and 5000.00 BRL, while only 16.3% reported being from low-income family (≤ 1000.00 BRL). The UFPel offers 63 classroom-based courses classified in nine areas of knowledge. The Applied Social Sciences area comprised 19% of the sample followed by the Linguistics, Letters and Arts (17%) area and the Health sciences area (13%). Conclusion: To the knowledge of researchers, this was the first cohort study of university students in the South of Brazil including more than two thousand participants. This paper described strategies adopted to optimize and to allow data collection in the baseline and in the next follow-ups

A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population

Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Demographic and Clinical Profile of Oral Squamous Cell Carcinoma from a Service-Based Population

Abstract The aim of this study was to evaluate the demographic and clinical profile of the oral squamous cells carcinoma (OSCC) cases registered in a center of oral diagnosis in southern Brazil. Eight hundred and six individuals with OSCC from 1959 to 2012 were included in this study. The variables recorded were: sex, age, occupation according to workplace, alcohol and tobacco consumption, skin color, tumor location, histological type, clinical appearance, size, evolution time, presence of pain and lymph node metastasis. Descriptive analysis was performed and the associations between variables were assessed using the chi-square and Fisher's exact test, with a confidence level of 5%. OSSC was more common in males (76.6%) aged between 51 to 70 years (53.9%). The most frequent sites were lower lip vermilion (23.3%), tongue (20.2%) and gingiva/alveolar ridge (18.1%). There was a strong association between outdoor occupation and white skin color with lip squamous cell carcinoma (LSCC). OSCC intraoral lesions were commonly more painful, larger than 2 cm and presented lymphatic metastasis. In conclusion, most of the results confirm the data from literature about sex, age, tumor location and occupation. Moreover, the positive correlations between LSCC and occupation, between LSCC and white skin color, and between bigger lesions and presence of pain/cervical metastasis also corroborate the literature data.

Resumo O objetivo desse estudo foi avaliar o perfil clínico-demográfico dos casos de carcinoma de células escamosas oral (CCEO) oral registrados em um centro de diagnóstico bucal no Sul do Brasil. Oitocentos e seis indivíduos com CCEO de 1959 a 2012 foram incluídos no estudo. As variáveis coletadas foram: sexo, idade, ocupação de acordo com o ambiente de trabalho, consumo de álcool e tabaco, cor de pele, localização do tumor, tipo histológico, aparência clínica, tamanho, tempo de evolução, presença de dor e metástase linfonodal. Foi realizada análise descritiva e as associações entre as variáveis foram avaliadas usando qui-quadrado e teste exato de Fisher, com nível de confiança de 5%. CCE oral foi mais comum em homens (76,6%), entre 51 e 70 anos de idade (53,9%). Os sítios mais frequentes foram vermelhão de lábio inferior (23,3%), língua (20,2%) e gengiva/rebordo alveolar (18,1%). Houve uma forte associação entre ocupação em ambiente externo e cor de pele branca com CCEO em lábio. Lesões intraorais de CCEO foram comumente mais dolorosas, maiores que 2 cm e apresentaram metástase linfática. Em conclusão, a maioria dos resultados confirma os dados da literatura em relação a sexo, idade, localização do tumor e ocupação. Além disso, as correlações positivas entre CCE em lábio e ocupação, entre CCEO em lábio e cor de pele branca, e entre lesões maiores e presença de dor/metástase cervical também corroboram os dados da literatura.

Does cryopreservation affect the biological properties of stem cells from dental tissues? a systematic review

Abstract This systematic review evaluated if different cryopreservation protocols could affect biological properties (Cell survival rate (CSR), proliferation, differentiation, maintenance of stem cell markers) of stem cells obtained from dental tissues (DSC) post-thaw. An electronic search was carried out within PubMed and ISI Web Science by using specific keyword. Two independent reviewers read the titles and abstracts of all reports respecting predetermined inclusion/exclusion criteria. Data were extracted considering the biological properties of previously cryopreserved DSCs and previously cryopreserved dental tissues. DSCs cryopreserved as soon as possible after their isolation presents a CSR quite similar to the non-cryopreserved DSC. Dimethyl sulfoxide (DMSO) [10%] showed good results related to cell recovery post-thaw to cryopreserve cells and tissues for periods of up to 2 years. The cryopreservation of DSC in a mechanical freezer (-80°C) allows the recovery of stem cells post-thaw. The facilities producing magnetic field (MF), demand a lower concentration of cryoprotectant, but their use is not dispensable. It is possible to isolate and cryopreserve dental pulp stem cell (DPSC) from healthy and diseased vital teeth. Cryopreservation of dental tissues for late DSC isolation, combined with MF dispensability, could be valuable to reduce costs and improve the logistics to develop teeth banks.

Resumo Essa revisão sistemática avaliou se diferentes protocolos de criopreservação podem afetar as propriedades biológicas (taxa de sobrevivência celular, proliferação, diferenciação, manutenção dos marcadores de superfície) de células-tronco isoladas de tecidos dentais (DSC) após o descongelamento. Uma busca eletrônica foi realizada no PubMed e no ISI Web of Science utilizando palavras-chave específicas. Dois revisores independentes avaliaram os títulos e resumos de todos os estudos respeitando critérios de inclusão e exclusão previamente determinados. Os dados foram extraídos considerando as propriedades biológicas de DSC, e DSC isoladas de tecidos previamente criopreservados. DSC criopreservadas logo após seu isolamento apresentaram propriedades biológicas muito semelhantes às observadas em DSC não criopreservadas. Dimetil sulfóxido (DMSO) [10%] demonstrou bons resultados relacionados com a recuperação celular após descongelamento de células e tecidos, por períodos de até 2 anos. A criopreservação de DSC em freezer mecânico (-80 °C) permite a recuperação de células-tronco pós-descongelação. A utilização de freezer com campo magnético (MF), proporciona a utilização de uma menor concentração de crioprotector, mas a sua utilização não é dispensável. É possível isolar e criopreservar e criopreservar células-tronco da polpa dental (DPSC) de dentes vitais saudáveis e doentes. Criopreservação de tecidos dentais após o isolamento de DSC, combinados com MF, podem ser valiosas estratégias para reduzir custos e melhorar a logística no desenvolvimento de bancos de dentes.

Immunohistochemical expression of TGF-ß1 and osteonectin in engineered and Ca(OH)2-repaired human pulp tissues

Abstract The aim of the present study was to evaluate the expression of transforming growth factor-β1 (TGF-β1) and osteonectin (ON) in pulp-like tissues developed by tissue engineering and to compare it with the expression of these proteins in pulps treated with Ca(OH)2 therapy. Tooth slices were obtained from non-carious human third molars under sterile procedures. The residual periodontal and pulp soft tissues were removed. Empty pulp spaces of the tooth slice were filled with sodium chloride particles (250-425 µm). PLLA solubilized in 5% chloroform was applied over the salt particles. The tooth slice/scaffold (TS/S) set was stored overnight and then rinsed thoroughly to wash out the salt. Scaffolds were previously sterilized with ethanol (100-70°) and washed with phosphate-buffered saline (PBS). TS/S was treated with 10% EDTA and seeded with dental pulp stem cells (DPSC). Then, TS/S was implanted into the dorsum of immunodeficient mice for 28 days. Human third molars previously treated with Ca(OH)2 for 90 days were also evaluated. Samples were prepared and submitted to histological and immunohistochemical (with anti-TGF-β1, 1:100 and anti-ON, 1:350) analyses. After 28 days, TS/S showed morphological characteristics similar to those observed in dental pulp treated with Ca(OH)2. Ca(OH)2-treated pulps showed the usual repaired pulp characteristics. In TS/S, newly formed tissues and pre-dentin was colored, which elucidated the expression of TGF-β1 and ON. Immunohistochemistry staining of Ca(OH)2-treated pulps showed the same expression patterns. The extracellular matrix displayed a fibrillar pattern under both conditions. Regenerative events in the pulp seem to follow a similar pattern of TGF-β1 and ON expression as the repair processes.

Influence of Poly-L-Lactic Acid Scaffold's Pore Size on the Proliferation and Differentiation of Dental Pulp Stem Cells

The aim of this study was to evaluate the influence of the poly-L-lactic acid (PLLA)-based scaffold's pore size on the proliferation and differentiation of dental pulp stem cells (DPSCs). The scaffolds were prepared in pulp chambers of 1-mm-thick tooth slices from third molars using salt crystals (150-250 µm or 251-450 µm) as porogen. DPSC (1x105 cells) were seeded in the scaffolds with different pore sizes, and cultured in 24-well plates. The cell proliferation was evaluated using the WST-1 assay after 3-21 days. Furthermore, RT-PCR was used to assess the differentiation of the DPSCs into odontoblasts, using markers of odontoblastic differentiation (DSPP, DSP-1 and MEPE). RNA from human odontoblasts was used as control. Cell proliferation rate was similar in both scaffolds except at the 14th day period, in which the cells seeded in the scaffolds with larger pores showed higher proliferation (p<0.05). After 21 days DPSCs seeded in both evaluated scaffolds were able of expressing odontoblastic markers DMP-1, DSPP and MEPE. In summary, both scaffolds tested in this study allowed the proliferation and differentiation of DPSCs into odontoblast-like cells.

O objetivo desse estudo foi avaliar a influência do tamanho dos poros de um scaffold à base de poli ácido láctico (PLLA) sobre a proliferação e diferenciação de células tronco da polpa dental (dental pulp stem cells - DPSC). Os scaffolds foram preparados dentro da câmara pulpar de discos de terceiros molares (1 mm), utilizando sal como porógeno (150-250 µm ou 251-450 µm). DPSC (1x105 células) foram semeadas nos scaffolds com diferentes tamanhos de poros e cultivadas em placas de 24 poços. A proliferação celular foi avaliada utilizando WST-1 após 3-21 dias. Além disso, RT-PCR foi utilizado para avaliar a diferenciação odontoblástica das DPSC utilizando marcadores da diferenciação odontoblástica (DSPP, DMP-1 e MEPE). RNA obtido de odontoblastos humanos foi utilizado como controle. A taxa de proliferação celular foi semelhante nos dois scaffolds avaliados, exceto no 14° dia, no qual as células cultivadas nos scaffolds com os maiores poros apresentaram uma maior taxa de proliferação (p<0,05). Após 21 dias, as DSPC cultivadas em ambos scaffolds avaliados foram capazes de expressar os marcadores odontoblásticos DMP-1, DSPP e MEPE. Em resumo, ambos scaffolds avaliados nesse estudo permitiram a proliferação e diferenciação odontoblástica das DPSC. .

Iniquidades em saúde bucal: escolares beneficiários do Bolsa Família são mais vulneráveis? / Inequalities in oral health: are schoolchildren receiving the Bolsa Família more vulnerable? / Inequidades en salud bucal: escolares beneficiarios de la Beca Familia son más vulnerables?

OBJECTIVE: To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren.METHODS: A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval).RESULTS: Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools.CONCLUSIONS: Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.

OBJETIVO: Analisar a associação entre ser beneficiário do Programa Bolsa Família e condições de saúde bucal entre escolares.MÉTODOS: Estudo transversal com 1.107 escolares entre oito e 12 anos de idade, provenientes de 20 escolas públicas e particulares da cidade de Pelotas, RS, em 2010. Os beneficiários do Programa Bolsa Família foram verificados por meio de lista fornecida pelas escolas participantes do estudo. Informações demográficas, socioeconômicas, de uso de serviço odontológico e de higiene bucal foram obtidas por meio de questionários respondidos pelos escolares e por seus pais. O exame clínico avaliou a presença de placa dental e experiência de cárie. Os dados foram analisados por meio dos testes do Qui-quadrado e Qui-quadrado de tendência linear e por regressão de Poisson (razão de prevalência; intervalo de confiança de 95%).RESULTADOS: Crianças de família não nuclear, que apresentavam CPOD ≥ 1 e que nunca haviam feito uso de serviço odontológico na vida estiveram associadas ao recebimento do Programa Bolsa Família. O modelo final mostrou que a prevalência de cárie foi duas vezes maior (RP 2,00; IC95% 1,47;2,69) em alunos beneficiários do Programa que também apresentaram maior severidade da doença, quando comparados aos alunos de escolas particulares (RM 1,53; IC95% 1,18;2,00). A prevalência de escolares que nunca haviam ido ao dentista foi mais de seis vezes maior em beneficiários do Programa Bolsa Família (RP 6,18; IC95% 3,07;12,45), em comparação com aqueles das escolas privadas, após ajustes.CONCLUSÕES: Escolares beneficiários do Programa Bolsa Família possuem maior carga de cárie e são os que menos acessam os serviços odontológicos. Esses achados sugerem a necessidade de incorporação da saúde bucal nas condicionalidades do Programa Bolsa Família.

OBJETIVO: Analizar la asociación entre ser beneficiario del Programa Beca Familia y condiciones de salud bucal entre escolares.MÉTODOS: Estudio transversal con 1.107 escolares entre ocho y 12 años de edad, provenientes de 20 escuelas públicas y privadas de la ciudad de Pelotas, RS, Brasil, en 2010. El beneficiario del Programa Beca Familia fue verificado por medio de lista suministrada por las escuelas participantes del estudio. Informaciones demográficas, socioeconómicas, de uso de servicio odontológico y de higiene bucal fueron obtenidas por medio de cuestionarios respondidos por los escolares y por sus padres. El examen clínico evaluó la presencia de placa dental y experiencia de caries. Los datos fueron analizados por medio de las pruebas de Chi-cuadrado y Chi-cuadrado de tendencia linear y por regresión de Poisson (cociente de prevalencia; intervalo de confianza de 95%).RESULTADOS: Niños de familia no nuclear, que presentaban COPD ≥1 y que nunca habían hecho uso de servicio odontológico en la vida estuvieron asociados al recibimiento en el Programa Beca Familia. El modelo final mostró que la prevalencia de caries fue dos veces mayor (RP 2,00; IC95% 1,47;2,69) en alumnos beneficiarios del Programa que también presentaron mayor severidad de la enfermedad, al ser comparados con los alumnos de escuelas privadas (RR 1,53; IC95% 1,18;2,00). La prevalencia de escolares que nunca habían ido al dentista fue más de seis veces mayor en beneficiarios del Programa Beca Familia (RP 6,18; IC95% 3,07;12,45), en comparación con aquellos de escuelas privadas, posterior a los ajustes.CONCLUSIONES: Escolares beneficiarios del Programa Beca Familia poseen mayor carga de caries y son los que menos tienen hacen uso de los servicios odontológicos. Estos resultados sugieren la necesidad de incorporar salud bucal en las condiciones del Programa Beca Familia.

Preferences on Vital and Nonvital Tooth Bleaching: A Survey Among Dentists from a City of Southern Brazil

This study evaluated the preferences of general dentists regarding vital and nonvital tooth bleaching therapies and investigated whether the time of clinical practice and post-graduate training influence these options. A cross-sectional study was conducted using a questionnaire with closed questions applied to dentists (n=276) of a mid-sized city of the southern Brazil (Pelotas, RS). Information was collected regarding sociodemographic variables, level of specialization and time since graduation. In addition, options regarding bleaching therapies including the first choice of material, technique and clinical practice for vital and nonvital tooth bleaching therapies were included. Data were submitted to descriptive analysis and the associations were evaluated using chi-square and Fisher exact tests (α=0.05). The response rate was 68% (n=187). At-home bleaching therapy was broadly preferred (78.1%) over in-office (21.9%) bleaching. For at-home bleaching, most dentists answered to use 10% carbamide peroxide (CP) (40.2%) and >30% hydrogen peroxide (HP) (31.7%) for nonvital therapies. The majority of dentists with post-graduation training preferred at-home bleaching techniques (p=0.003). At-home bleaching therapy was also more indicated by younger dentists. No association was found between the choice for nonvital bleaching therapies and time since graduation (p=0.532) or continuous education (p=0.083). In conclusion, at-home bleaching was preferred over in-office therapies; 10% CP and >30% HP were chosen as first option agents to treat discolored vital and nonvital teeth, respectively. The time in clinical practice and the level of specialization affected dentists' choices only for vital tooth bleaching treatment.

Este estudo avaliou as preferências de cirurgiões-dentistas sobre o clareamento de dentes vitais e não-vitais. Também investigou a possível relação entre o grau de formação profissional e as decisões clínicas tomadas por estes profissionais. Para isso, realizamos um estudo transversal. Cirurgiões-dentistas (n=276) de uma cidade de médio porte do sul do Brasil (Pelotas, RS) receberam um questionário contendo perguntas sobre informação sócio-demográfica, nível de especialização e ano de graduação. Adicionalmente, foram realizadas perguntas sobre o material de primeira escolha, técnicas e práticas clínicas relacionadas a clareamento de dentes vitais e não vitais. Os dados obtidos foram submetidos à análise descritiva e as possíveis associações entre variáveis foram avaliadas utilizando o teste Qui-Quadrado e teste Exato de Fisher (p<0,05). A taxa de resposta foi de 68% (187). A técnica de clareamento caseiro supervisionada foi preferida (78,1%) em detrimento da técnica em consultório (21,9%). Os dentistas escolheram preferentemente o peróxido de carbamida (PC) a 10% para clareamento vital caseiro (40,2%) e o peróxido de hidrogênio (PH) >30% para o clareamento de dentes despolpados (31,7%). A maioria dos dentistas que realizaram cursos de pós-graduação preferiram o clareamento caseiro (p=0,003). Além disso, o clareamento caseiro foi mais indicado pelos dentistas mais jovens. Não foi encontrada relação entre as escolhas para clareamento de dentes despolpados e ano de graduação (p=0,532) ou grau de formação (p=0,083). O clareamento vital caseiro foi escolhido em detrimento das técnicas de consultório; CP a 10% e HP > 30% foram os agentes de escolha para o tratamento de dentes vitais e não vitais escurecidos, respectivamente. O tempo de prática clínica e o nível de especialização foram associados com as escolhas dos dentistas somente para clareamento de dentes vitais.

Tenascin and Fibronectin Expression after Pulp Capping with Different Hemostatic Agents: A Preliminary Study

This study investigated the expression of extracellular matrix glycoproteins tenascin (TN) and fibronectin (FN) in pulp repair after capping with calcium hydroxide (CH), following different hemostasis protocols. Class I cavities with a pulp exposure were prepared in 42 human third molars scheduled for extraction. Different hemostatic agents (0.9% saline solution, 5.25% sodium hypochlorite and 2% chlorhexidine digluconate) were used and pulps were capped with CH cement. After 7, 30 or 90 days, teeth were extracted, formalin-fixed, and prepared for immunohistochemical technique. Hemostatic agents did not influence the expression of TN and FN. Both glycoproteins were found in the entire the pulp tissue and around collagen fibers, but were absent in the mineralized tissues. In the predentin, TN showed positive immunostaining and FN had a variable expression. Within 7 days post-treatment, a slightly more pronounced immunostaining on the pulp exposure site was observed. Within 30 days, TN and FN demonstrated a positive expression around the dentin barrier and at 90 days, a thin and linear expression of TN and FN was delimitating the reparative dentin. In conclusion, hemostatic agents did not influence TN and FN expression. Immunostaining for TN and FN was seen in different regions and periods, demonstrating their role in pulp repair.

Este estudo investigou a expressão das glicoproteínas Tenascina (TN) e Fibronectina (FN) da matriz extracelular no reparo pulpar após capeamento com hidróxido de cálcio (HC), seguindo diferentes protocolos de hemostasia. Cavidades de classe I com exposição pulpar foram preparadas em 42 terceiros molares humanos indicados para extração. Diferentes agentes hemostáticos (solução salina a 0,9%, hipoclorito de sódio a 5,25% e clorexidina a 2%) foram usados e as polpas foram capeadas com cimento de HC. Após 7, 30 ou 90 dias, os dentes foram extraídos, fixados em formalina e preparados para análise imunoistoquímica. Os agentes hemostáticos não influenciaram a expressão de TN e FN. Ambas glicoproteínas foram encontradas em todo tecido pulpar, ao redor das fibras colágenas e estiveram ausentes nos tecidos mineralizados. Na pré-dentina, a TN mostrou forte imunoexpressão e a FN teve uma expressão variável. Após 7 dias, foi observada uma expressão levemente mais pronunciada no lugar da exposição pulpar. Aos 30 dias, a TN e a FN demonstraram uma expressão mais forte sob a barreira dentinária e aos 90 dias, uma expressão fina e linear da TN e FN apresentava-se delimitando a dentina reparativa. Em conclusão, os agentes hemostáticos não influenciaram e expressão da TN e da FN. A imunoexpressão da TN e FN foi observada em diferentes regiões e períodos, demonstrando o seu papel no reparo pulpar.

Factors associated with prevalence of oral lesions and oral self-examination in young adults from a birth cohort in Southern Brazil / Fatores associados à prevalência de lesões bucais e à realização do autoexame bucal em adultos jovens de uma coorte de nascidos vivos do Sul do Brasil / Factores asociados a la prevalencia de lesiones bucales y a la realización del autoexamen bucal en adultos jóvenes de una cohorte de nacidos vivos del sur de Brasil

The objective of this study was to assess the prevalence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regarding exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of individuals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.

O objetivo foi determinar a prevalência e características de lesões bucais, autoexame bucal e suas associações com determinantes ao longo da vida em uma população de adultos jovens. Uma amostra representativa (n = 720) dos nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1982, foi investigada, e a presença de lesões bucais e a realização do autoexame, verificadas aos 24 anos. As variáveis independentes foram obtidas de outros seguimentos dessa coorte. A prevalência de lesões bucais foi de 23,3% (IC95%: 20,3-26,6), e 31% dos indivíduos (IC95%: 27,6-34,4) relataram nunca ter realizado o autoexame da boca. A análise multivariável mostrou que o baixo nível socioeconômico ao nascimento, não ter recebido instrução de higiene oral até os 15 anos de idade e fumar aos 22 anos foram associados à presença de lesões. A realização do autoexame bucal esteve associada à maior escolaridade materna ao nascimento e a ter recebido orientação de higiene bucal pelo dentista aos 15 anos. Fatores socioeconômicos e comportamentais estão associados tanto à presença de lesões bucais quanto à realização do autoexame bucal.

El objetivo fue determinar la prevalencia y características de lesiones bucales, autoexamen bucal, y sus asociaciones con determinantes a lo largo de la vida, en una población de adultos jóvenes. Fue investigada una muestra representativa (n = 720) de los nacidos en Pelotas, Río Grande do Sul, Brasil, 1982, y la presencia de lesiones bucales y realización del autoexamen fueron verificadas a los 24 años. Las variables independientes se obtuvieron de otros seguimientos de esta cohorte. La prevalencia de lesiones bucales fue de un 23,3% (IC95%: 20,3-26,6) y un 31% de los individuos (IC95%: 27,6-34,4) relató no haber realizado nunca el autoexamen de la boca. El análisis multivariable mostró que el bajo nivel socioeconómico en el momento del nacimiento, el no haber recibido instrucción de higiene oral hasta los 15 años de edad, y fumar a los 22 años, se asociaron a la presencia de lesiones. La realización del autoexamen bucal se asoció a una mayor escolaridad materna en el nacimiento y al haber recibido orientación de higiene bucal por el dentista a los 15 años. Factores socioeconómicos y de comportamiento están asociados, tanto la presencia de lesiones bucales, como a la realización del autoexamen bucal.

Etiologic factors associated with oral squamous cell carcinoma in non-smokers and non-alcoholic drinkers: a brief approach

Oral squamous cell carcinoma (OSCC) is the fifth most common type of cancer in the world. The effect of some etiological factors is well established in the literature, such as consumption of tobacco and alcohol. However, approximately 15 to 20% of all oral cancer cases occur in patients without the traditional risk factors, reflecting in numerous cases of OSCC in non-smokers and non-alcoholic drinkers. Also, several studies have suggested a possible association between human papillomavirus and OSCC. Under these aspects, the purpose of this study is to address cases of oral cancer in non-smokers and non-drinkers focusing on the role of HPV, thus contributing to improve the diagnosis and monitoring of OSCC. A computer database search was performed using the Pubmed database. The search key words were: epidemiology, oral squamous cell carcinoma, risk factors and human papillomavirus. It is important to assess patients without the potential risk factors, since this knowledge may help identifying other features associated with the occurrence of oral cancer, enabling an appropriate clinical management and monitoring.

O carcinoma espinocelular (CEC) de boca é o quinto mais comum no mundo. O efeito de alguns fatores etiológicos está bem estabelecido na literatura, como o fumo e o consumo de álcool. No entanto, aproximadamente 15 a 20% dos casos de câncer bucal acometem pacientes sem os tradicionais fatores de risco e isso se traduz em inúmeros casos de CEC bucais em indivíduos não fumantes e não etilistas. Além disso, dados da literatura têm sugerido uma possível associação entre o vírus papiloma humano (HPV) e o carcinoma espinocelular de boca. Em virtude desse aspecto, desenvolveu-se este trabalho na perspectiva de revisar as características mais associadas a esse grupo de pacientes, contribuindo assim para a melhoria no diagnóstico e no acompanhamento dos mesmos. Os artigos que serviram de apoio para o estudo foram localizados por meio da base de dados Pubmed, utilizando os descritores "epidemiologia", "carcinoma espinocelular de boca", "fatores de risco" e "vírus papiloma humano". É importante avaliar pacientes sem tais fatores de risco, uma vez que o conhecimento pode auxiliar na análise de outras características associadas com a ocorrência de carcinoma. Além disso, possibilita melhorar o manejo clínico e monitoramento.

Novel experimental cements for use on the dentin-pulp complex

This aim of this study was to evaluate the physicochemical and biological properties of novel experimental cements (Hybrid, Paste and Resin) based on synergistic combinations of existing materials, including pH, diametral tensile strength (DTS) and cytotoxicity comparing them with mineral trioxide aggregate (MTA - Angelus®) and a glass ionomer cement (GIC) developed at our laboratory. For the physicochemical and biological tests, specimens with standard dimensions were produced. pH measurements were performed with digital pH meter at the following time intervals: 3, 24, 48 and 72 h. For the DTS test, cylindrical specimens were subjected to compressive load until fracture. The MTT assay was performed for cytotoxicity evaluation. Data were analyzed by ANOVA and Tukey's test (α=0.05). Paste group showed pH values similar to MTA, and Hybrid group presented pH values similar to GIC (p>0.05). The tested materials showed pH values ranging from alkaline to near neutrality at the evaluated times. MTA and GIC showed similar DTS values. The lowest and highest DTS values were seen in the Paste and Resin groups, respectively (p<0.05). Cell viability for MTA and experimental Hybrid, Paste and Resin groups was 49%, 93%, 90% and 86%, respectively, when compared with the control group. The photo-cured experimental resin cement showed similar or superior performance compared with the current commercial or other tested experimental materials.

O objetivo deste estudo foi avaliar propriedades físico-químicas e biológicas de novos cimentos experimentais (Híbrido, Pasta e Resinoso) baseado na combinação sinérgica de materiais existentes, incluindo pH, resistência à tração diametral (RTD) e citotoxidade, comparando-os ao MTA (Angelus®) e a um cimento de ionômero de vidro (CIV) desenvolvido em nosso laboratório. Para a realização dos testes físico-mecânico e biológico, foram confeccionados espécimes com dimensões padrão. O teste de pH foi realizado por meio de pH-metro digital nos tempos: 3, 24, 48 e 72 h. Para o teste de RTD, espécimes cilíndricos foram submetidos a carga compressiva até sua fratura. Para avaliação da citotoxidade, utilizou-se o teste MTT. Os dados foram analisados utilizando ANOVA e teste de Tukey (α=0,05). O grupo Pasta apresentou valores de pH semelhantes ao MTA, assim como o grupo Híbrido seguiu os parâmetros do CIV (p>0,05). Todos os materiais apresentaram valores de pH alcalinos ou próximosà neutralidade nos tempos avaliados. MTA e CIV apresentaram valores de RTD similares. Os menores e maiores valores observados foram do grupo Pasta e Resinoso, respectivamente (p<0,05). A viabilidade celular para os grupos MTA, Híbrido, Pasta, Resinoso, quando comparados ao grupo controle foi de: 49, 93, 90 e 86%, respectivamente. O cimento experimental Resinoso apresentou desempenho similar ou superior aos materiais comerciais e experimentais avaliados.

Prevalence of percutaneous injuries and associated factors among dental surgeons / Prevalência de acidentes perfurocortantes e fatores associados entre cirurgiões-dentistas

PURPOSE: The practice of dentistry usually involves contact with secretions from the oral cavity through percutaneous injuries, which is a risk factor for the transmission of infections, especially hepatitis B, between the professional and patients. This study aimed to assess the prevalence of percutaneous injuries and associated factors among dental surgeons. METHODS: A total of 187 dental surgeons from the city of Pelotas, Brazil, participated in this study. Data concerning the socio-demographic aspects, occurrence of accidents, types of instruments, use of personal protective equipment, immunization coverage related to hepatitis B and tests for serum conversion were collected through self-reported questionnaires. The data underwent descriptive analysis and chi-square testing or Fisher's exact test, with P<0.05. RESULTS: The prevalence of percutaneous injuries was 59.8%, and there was no association with the risk factors evaluated. Of the dentists interviewed, 97.3% had been vaccinated against hepatitis B; however, only 86.2% had received the three recommended doses. The use of probes and handling needles were the most common causes of percutaneous injuries (37.0% and 29.0%, respectively). CONCLUSION: The results showed that the prevalence of percutaneous injuries was high among dental surgeons, and there is a need for emphasis on the prevention of hepatitis B through the administration of the three vaccine doses and the use of personal protective equipment.

OBJETIVO: A prática dental geralmente envolve contato com secreções oriundas da cavidade bucal, através de injúrias percutâneas, sendo um fator de risco para transmissão de infecções entre profissionais e pacientes, especialmente hepatite B. Este estudo objetivou avaliar a prevalência de injúrias percutâneas e fatores associados entre cirurgiões-dentistas. MÉTODOS: Um total de 187 dentistas da cidade de Pelotas, RS, Brasil, participou deste estudo. Dados sobre aspectos socio-demográficos, ocorrência de acidentes, tipos de instrumentos, uso de equipamento de proteção, imunização relacionada à hepatite B e teste para avaliação de soroconversão foram coletados mediante questionário auto-administrado. Os dados foram submetidos à análise descritiva e testes do Qui-Quadrado de Pearson e Fisher para avaliar associação entre o desfecho e as variáveis preditoras, com nível de significância de 0,05. RESULTADOS: A prevalência de acidentes perfurocortantes foi de 59.8% e não houve associação com os fatores de risco avaliados. Dos dentistas participantes, 97.3% tinham sido vacinados conta a hepatite B, entretanto, 86.2% tinham tomado as três doses recomendadas. O uso de sondas e agulhas foram os maiores agentes causadores de acidentes, respectivamente 37.0% e 29.0%. CONCLUSÃO: Os resultados mostraram que a prevalência de injúrias percutâneas foi elevada entre dentistas e há necessidade de ênfase em prevenção de hepatite B através de adoção das três doses e uso de equipamento de proteção individual.

Oral health studies in the 1982 Pelotas (Brazil) birth cohort: methodology and principal results at 15 and 24 years of age / Estudo longitudinal de saúde bucal na coorte de nascidos vivos em Pelotas, Rio Grande do Sul, Brasil, 1982: aspectos metodológicos e resultados principais aos 15 e 24 anos de idade

The aim of this study was to describe the methodology and results of oral health studies nested in a birth cohort in Pelotas, Southern Brazil. For the oral health studies a sub-sample (n = 900) was selected from the cohort and dental examinations and interviews were performed at ages 15 (n = 888) and 24 years (n = 720; 81.1 percent). Data collection included dental outcomes, dental care, oral health behaviors, and use of dental services. Mean DMF-T varied from 5.1 (SD = 3.8) to 5.6 (SD = 4.1) in the study period. The proportion of individuals with at least one filled tooth increased from 51.9 percent to more than 70 percent. Individuals who had always been poor used dental services less and had fewer healthy teeth on average than those who had never been poor. Individuals with decreasing or increasing family income trajectories showed intermediate values. An increase was seen in the number of healthy teeth from age 15 to 24 only among those who had never been poor. A history of at least one experience with poverty had a negative impact on oral health in adulthood.

Descreveu-se a metodologia e os resultados dos estudos de saúde bucal em uma coorte de nascimentos. Em 1997, uma amostra da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, (n = 900) foi sorteada para o estudo de saúde bucal (15 anos) e os mesmos indivíduos foram novamente investigados aos 24 anos. Agravos bucais, cuidados com a saúde bucal e uso de serviços odontológicos foram avaliados. Participaram do estudo 888 adolescentes aos 15 anos e 720 (81,1 por cento) aos 24. O índice CPO-D médio variou de 5,1 (DP = 3,8) a 5,6 (DP = 4,1) no período. Ter pelo menos um dente restaurado passou de 51,9 por cento aos 15 anos para mais de 70 por cento aos 24. A proporção do uso de serviços e a média de dentes saudáveis foram menores dentre os sempre pobres quando comparados àqueles nunca pobres. Indivíduos com trajetórias econômicas descendente ou ascendente tiveram valores intermediários. Aumento de dentes saudáveis dos 15 aos 24 anos foi observado apenas dentre aqueles nunca pobres. Apresentar pelo menos um episódio de pobreza ao longo da vida impactou na saúde bucal na vida adulta.

Oral lichenoid lesions associated with amalgam restorations: report of two cases / Lesões liquenóides bucais associadas a restaurações de amálgama: relatos de dois casos

PURPOSE: Dental amalgam has been used as a dental restoration for more than 165 years. However, some patients with these restorations may present oral lichenoid lesions (OLL). OLL are chronic oral mucosal contact reactions to dental amalgam. Their diagnosis usually is based on the direct contact of the affected mucosa with the amalgam restorations, clinical appearance, and lack of migrations. A patch-test for mercury can be performed to confirm the diagnosis. Thus, the objective this work was to discuss the occurrence of this disease and your possibilities of existing differential diagnostic. CASE DESCRIPTION: Two clinical cases were diagnosed as related to OLL. In both cases, the patients complained of a burning sensation in the oral mucosa adjacent to the amalgam restorations. The treatment involved replacing the amalgam restorations by composite. A complete remission of the painful symptoms was observed after 17 days in one case and after one month in the other, although the lesions in the oral mucosa did not disappear completely. CONCLUSION: Dentists should be aware of OLL occurrence close to amalgam restorations and should be able to diagnose it and recommend the best treatment option.

OBJETIVO: O amálgama dentário tem servido como restaurador dentário a mais de 165 anos. Entretanto, alguns pacientes com estas restaurações têm demonstrado a ocorrência de lesões liquenóides orais (LLO). As LLO são reações de contato da mucosa oral crônicas ao amálgama dentário. Geralmente, o diagnóstico da lesão é feito pelo contato direto da mucosa afeta com a restauração de amalgama, pela aparência clínica, e a ausência de migrações. Um teste de contato para o mercúrio pode ser realizado para confirmar o diagnóstico. Assim, o objetivo deste trabalho foi discutir a ocorrência desta doença e suas possibilidades de diagnóstico diferencial existentes. DESCRIÇÃO DO CASO: Dois casos clínicos foram diagnosticados como LLO. Em ambos os casos, os pacientes relataram sofrer de sensação de queimação na mucosa oral adjacente às restaurações de amálgama. Para ambos pacientes, os tratamentos envolveram a substituição das restaurações de amálgama. Completa remissão da sintomatologia dolorosa foi observada após 17 dias em um caso e após 30 dias em outro, embora as lesões na mucosa intrabucal não tenham desaparecido completamente. CONCLUSÃO: Os cirurgiões-dentistas devem estar cientes da ocorrência da LLO relacionadas a restaurações de amálgama e devem saber como fazer o diagnóstico correto para assim recomendar a melhor forma de tratamento.